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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
Open this folder and view contentsCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
close this folderCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
View the document11.1 Neurological complications with secondary mental manifestations
View the document11.2 Changes in mental status - Delirium (acute organic brain syndrome)
View the document11.3 Changes in mental status - AIDS related dementia (ADC) (chronic organic brain syndrome)
View the document11.4 Changes in mental status - AIDS Related Mania
close this folder11.5 Mental complications
View the document11.5.1 Adjustment disorder
View the document11.5.2 Major Depressive Disorder
View the document11.5.3 Alcohol and substance use disorders
View the document11.5.4 Bereavement and bereavement counseling
View the document11.6 Crisis and crisis counseling
View the document11.7 Persons with previous mental disorders
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

11.5.3 Alcohol and substance use disorders

All patients seen for ART treatment should be assessed for alcohol and other drug use as part of lifestyle assessment. Alcohol use should raise concern if more that 5 units of alcohol are used per week; ideally patients should be advised to stop drinking if possible. Use of other drugs should raise concern, the common drugs used/abused in this context being cannabis in its marihuana form, inhalants (amongst adolescents), khat, heroin and to a lesser extent cocaine. For both alcohol and other drug use, concern is raised due to the disinhibiting effects of use that inhibit HIV/AIDS risk reduction plans implementation, effects on immune status (alcohol and cannabis), and as potential barriers to adherence. Heroin and free-based cocaine use has the additional transmission risk through un-sterile needles for intravenous drug users.

In patients with alcohol and drug use problems, these should be addressed in counseling sessions.

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